Children who present with a diagnosis of Down Syndrome can have difficulty with their speech, language and feeding. The frequent co-occurrence of hearing loss, oral-motor problems, memory and auditory processing difficulties can compound communication difficulties. Despite these difficulties, many children who present with Down Syndrome are sociable communicators. Most children with Down syndrome can understand much more language than they can express.
To maximise language development and support of communication language therapy intervention is best started as early as possible. A Speech and Language Therapist can assess and provide individualised intervention for the speech and language difficulties with which each child with Down Syndrome presents. When therapy commences goals are set with parents. Early intervention goals are client centred and meaningful, focusing on the individual’s communication priorities, in addition to building pre-verbal communication skills such as shared attention, listening, engagement and use of gesture. Exercises may be provided to increase muscle tone in the mouth in conjunction with speech exercise to support speech production. Additionally, the development of overall understanding and use of language is targeted.
Although many children with Down Syndrome develop the ability to use verbal speech as a means of communication, generally a desire to communicate and understanding is present prior to the ability to communicate verbally. A Total Communication approach provides a child with an output system to communicate when he or she has not yet developed the skills needed for speech. It can involve the use of signs, gesture and pictures to augment communication and teach language. When following this approach, adults use a sign system such as LAMH and speech when talking with the child. The child learns signs in conjunction with speech and uses these signs to communicate.
What can I do to help my child?
Children learn well through play and daily routines, so this is a good place to start. Some routine structured practice for communication is also a good idea.
As mentioned above a Total Communication approach is preferable.
Here are some useful tips:
- Give your child choices between items to encourage pointing and gesture and other non-verbal communications. Encourage all attempts at communication be they non- verbal or verbal, reinforcing gesture or any potential word use.
- Label for your child and repeat, keeping background noise to a minimum
- Model good eye contact
- Support verbal with visual
- Create opportunities for your child to use their communication
- Provide extra time for your child to process the language they hear as processing time can be longer
- Reduce your language load by using short clear but complete sentences.
- Explore the possibility of the use of LAMH. The use of signs paired with verbal language provides a supportive visual symbol to teach language meaning in addition to supporting its use. In general, as spoken language increases, signing reduces.
- Written printed words can support oral communication. Often, teaching reading can enhance verbal communication skills
- Similarly, visual aids such as PECS cards can help communication and ease frustration in young children with speech and language difficulties. Use the visual aids as a support to speech instead of an alternative, by always speaking when using them, and encouraging the child to do so also
- Print can be used to support oral language development from an early age, as many children with Down syndrome find remembering written words easier than spoken words. Teaching reading can improve oral language skills. The “See and Learn” program can assist with this.
- Liaise with a Speech and Language Therapist who can provide individualised intervention for your child on a regular basis. This will help your child maximise their communication potential and provides a valuable source of support for both child and parent.
Elaine Baldwin, Senior Speech & Language Therapist at Sensational Kids, Clonakilty
Copyright Sensational Kids CLG 2018